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Biomedical subjects

H Lau

Publications and source records attributed to H Lau.

At least 73 records · Page 4Linked to original sources
PubMed1999

Epidemiology of atherosclerotic peripheral arterial occlusive disease in Hong Kong.

The epidemiology of atherosclerotic peripheral arterial disease (PAD) has rarely been studied in Asia. A prospective vascular registry consisting of 510 Chinese patients with PAD from a teaching hospital in Hong Kong disclosed a male/female ratio of 1.6:1.0 with a mean age of 72 years. The predominant pattern was femoropopliteal occlusive disease (49%). Half of all patients had tissue loss on presentation, more so in women (67%) than men (38%). Demographic and biochemical risk factors examined showed many similarities with the West, included smoking (59%), hypertension (55%), diabetes mellitus (42%), hypercholesterolemia (55%), elevated low density lipoprotein (LDL) (60%), triglycerides (31%), hyperfibrinogenemia (62%), and hyperglycemia (49%). Chinese female patients with PAD were older and had a high prevalence of diabetes mellitus (54%). Smoking is less a problem in women (28%). They suffered predominantly from femoropopliteal and distal vessel disease, and two-thirds presented with tissue loss. Female patients also have significantly higher levels of fasting glucose, cholesterol, triglyceride, LDL, and very low density lipoprotein (VLDL). Male patients were mostly smokers (80%) with a higher proportion of aortoiliac disease. Critical ischemia in the form of tissue loss was associated with female sex (p < 0.001), age (p < 0.001), nonsmoking (p < 0.001), diabetes (p < 0.005), a low hemoglobin/hematocrit (p < 0.001), a high white blood cell count (p < 0.001), and high levels of fibrinogen (p < 0.01) and cholesterol (p < 0.05). An increasing incidence of PAD was noted in Hong Kong. Most of the patients present late with advanced ischemia. It is possible that this disease pattern represents only a fraction of the true incidence of PAD in the territory.

Adolescent↗
PubMed1999

Irradiation-induced extracranial carotid stenosis in patients with head and neck malignancies.

BACKGROUND: Carotid stenosis is a recognized complication of external irradiation to the head and neck for malignancy. This study aim to investigate the pattern and prevalence of radiation induced carotid disease, and to identify risk factors associated with significant stenosis. METHODS: In a comparative cross-sectional study, carotid arteries color flow duplex scan was performed on 240 patients who had received external irradiation to the head and neck area, with a mean interval of 72 months from radiotherapy. They consisted of 181 men and 59 women, with a mean age of 59 years. Fifteen patients had a history of cerebrovascular symptoms. RESULTS: Internal carotid artery (ICA) stenosis of 70% or greater was detected in 29 arteries in 24 patients. Common carotid artery (CCA) disease of > or =70% was present in 13 arteries in 12 patients. Overall 28 patients had significant ICA/ CCA disease (11.7%). Patients with nasopharyngeal and laryngeal carcinoma had more cerebrovascular symptoms, and more frequent CCA stenosis. Significant ICA/CCA stenosis was associated with age, smoking, coronary heart disease, stroke, no head and neck surgery, time interval from radiotherapy, and the site of primary tumor. On logistic regression analysis age (>60 years), cerebrovascular symptoms, interval from irradiation (>5 years), and nasopharynx and larynx cancer were found to be independent significant (P<0.05) predictors of 70% or greater ICA/CCA stenosis. CONCLUSIONS: Patients who had received radiotherapy to the head and neck have a high risk of developing significant carotid stenosis. Routine duplex ultrasound screening in these patients is indicated.

Carotid Artery, Internal↗
PubMed1999

Impact of palivizumab on expected costs of respiratory syncytial virus infection in preterm infants: potential for savings.

In its clinical assessment of the respiratory syncytial virus (RSV)-specific monoclonal antibody palivizumab, the IMpact-RSV Study Group demonstrated a reduction in hospitalizations for RSV-related lower respiratory tract infection in infants who received prophylaxis compared with infants who did not receive prophylaxis. An assessment of the RSV-related expenses for managing both groups of infants is needed to provide insight into the value of prophylaxis. The present study was conducted to identify and compare RSV-related health care expenditures incurred by infants who did not receive prophylaxis throughout one RSV season and after. Using a decision-analytic model populated with data from the contemporary medical literature, a pharmacoeconomic study was conducted from the perspective of the payer. Probabilities for RSV-related hospitalizations of infants who did and did not receive prophylaxis were abstracted from several published studies. Components of inpatient and outpatient care were identified through examination of hospital records, reviews of the published literature, and consultation with expert clinicians. Charges related to prophylaxis and medical management of infection were abstracted from hospital billing records and published data. Appropriate charges were applied to decision-tree branches and multiplied by in-line probabilities for outcomes. Products at terminal nodes were summed to establish total expected charges for both groups of infants. Widespread clinical use of prophylactic palivizumab would result in incremental expenses < or =$3459 per infant or cost savings < or =$39,107 per infant. The variability in value of prophylaxis derives from the rate of RSV-related hospitalizations in the community and the total health care expense of managing infected infants.

Antibodies, Monoclonal↗
PubMed1999

Screening for asymptomatic carotid stenosis in patients with peripheral vascular disease: a prospective study and risk factor analysis.

Screening for asymptomatic carotid artery stenosis using color flow duplex scan was performed on 186 Chinese patients with peripheral vascular disease. They consist of 121 male and 65 females, with a mean age of 70.6 years. A carotid bruit was present in 43 (23.1%) of the patients. Internal carotid artery stenosis of 70% or greater was detected in 46 patients (24.7%) including six total occlusions. Another 79 patients (42.5%) had internal carotid artery stenosis in the 30-69% range. Significant internal carotid artery stenosis was associated with age, male sex, the quantity and duration of smoking and a carotid bruit, and inversely with cholesterol, triglyceride and VLDL. Age, the number of cigarettes consumed per day, and carotid bruit were independent significant predictors of > or =70% internal carotid artery stenosis on logistic regression analysis. The degree of internal carotid artery stenosis is more severe in patients with a carotid bruit, and correlated positively with age (P<0.01), the number of cigarettes smoked (P = 0.04), and the duration of smoking (P = 0.03). Multiple linear regression analysis showed that only the age of the patient bears a significant relationship with the degree of internal carotid artery stenosis (P<0.01). There was no relationship between the degree of lower limb ischemia with carotid stenosis. The prevalence of > or =70% internal carotid artery stenosis in a high risk population with peripheral vascular disease was 24.7%. Routine duplex screening is worthwhile in this group of patients, particularly in male, elderly smokers.

Aged↗
PubMed1999

Surgical implications of underestimation of adrenal tumour size by computed tomography.

BACKGROUND: Size of adrenal mass is an important consideration during adrenal surgery, with regard to the choice of surgical approach and management of adrenaloma. The aim of the present study was to evaluate the precision of preoperative computed tomography (CT) on the size estimation of adrenal lesions and to review its potential implications on surgical decision making. METHODS: Records of 110 patients who underwent adrenalectomy for various adrenal pathologies from 1981 to 1997 were reviewed retrospectively. Patients (n = 92) who had documented dimensions of adrenal mass by both preoperative CT and pathological examination were selected for analysis. RESULTS: CT overall underestimated the actual size of adrenal lesions by 16 per cent compared with measurement of resected specimens (mean 3.1 versus 3.6 cm; P < 0.001). There was a significant underestimation of the actual size of adrenal lesions measuring less than 6 cm by CT but not for lesions larger than 6.0 cm. Phaeochromocytoma (n = 17) was the only pathological condition consistently underestimated by CT. CONCLUSION: Conventional CT overall underestimates the real size of adrenal lesions, in particular phaeochromocytoma and adrenal tumours of less than 6.0 cm in size. Surgical decision making based on size should take this limitation into account.

Adrenal Gland Neoplasms↗
PubMed1999

Prevalence of significant carotid stenosis in Chinese patients with peripheral and coronary artery disease.

BACKGROUND: The prevalence of extracranial carotid stenosis in the Chinese population is not known. This study aims to investigate and compare carotid disease in several groups of high-risk patients. METHOD: Routine screening carotid duplex scans were performed on high-risk Chinese patients without cerebrovascular symptoms. These consisted of 249 patients with peripheral vascular disease, 207 patients with coronary artery disease, and 45 patients with abdominal aortic aneurysm. In addition, 220 patients with cerebrovascular symptoms and 58 patients with carotid bruits were scanned. A group of 108 healthy individuals was included as a control. The data of all 887 subjects were analysed. RESULTS: Carotid stenosis of 70% or greater was detected in 37.7% of patients in the cerebrovascular disease group and 24.5% of patients with peripheral arterial disease; it was higher than in patients with coronary artery disease (11.1%), asymptomatic carotid bruit (10.3%) and aortic aneurysms (8.9%; P < 0.001). No significant disease was found in the controls. Patients with cerebrovascular disease have more severe degrees of carotid stenosis and significantly more total occlusions. Smoking, age and male sex were the main risk factors for high-grade (> or = 70%) carotid stenosis. CONCLUSION: The prevalence of extracranial carotid stenosis in Chinese patients is not low. Patients with peripheral arterial disease have the highest risk of significant carotid stenosis: routine carotid duplex screening in these patients is recommended.

Aged↗
PubMed1999

Cortical activation during human volitional swallowing: an event-related fMRI study.

Functional magnetic resonance imaging (fMRI) provides a safe, noninvasive method for studying task-related cortical neuronal activity. Because the cerebral cortex is strongly implicated in the control of human swallowing, we sought to identify its functional neuroanatomy using fMRI. In 10 healthy volunteers, a swallow event-related paradigm was performed by injecting 5 ml water bolus into the oral cavity every 30 s. Whole brain functional magnetic susceptibility -weighted spiral imaging data were simultaneously acquired over 600 s on a 1.5-T magnetic resonance scanner, utilizing the blood oxygenation level-dependent technique, and correlation maps were generated using both >99% percentile rank and spatial extent thresholding. We observed areas of increased signal change consistently in caudal sensorimotor cortex, anterior insula, premotor cortex, frontal operculum, anterior cingulate and prefrontal cortex, anterolateral and posterior parietal cortex, and precuneus and superiomedial temporal cortex. Less consistent activations were also seen in posterior cingulate cortex and putamen and caudate nuclei. Activations were bilateral, but almost every region, particularly the premotor, insular, and frontal opercular cortices, displayed lateralization to one or the other hemisphere. Swallow-related cortical activity is multidimensional, recruiting brain areas implicated in processing motor, sensory, and attention/affective aspects of the task.

Adult↗
PubMed1999

Effect of meal timing not critical for the pharmacokinetics of tegaserod (HTF 919).

This study assessed the pharmacokinetic profiles of administering tegaserod (HTF 919) at different time intervals with respect to a meal. It was a randomized, open-label, two-phase, five-period crossover study. In the first phase, 18 healthy subjects received a single 12 mg oral dose of tegaserod administered either 30 or 15 minutes prior to the start of the 600-calorie, fat-rich breakfast. In the second phase, subjects received a single 12 mg oral dose of tegaserod 1 minute before, 2.5 hours after the start of meal, or with a continued 4-hour postdose fast. Safety assessment and plasma samples for the determination of drug concentration were obtained for 24 hours postdose. Noncompartmental analysis results indicated that the AUC of tegaserod was reduced by almost half under fed conditions compared to the fasted condition. Exploratory analyses were implemented to further investigate the absorption characteristics of tegaserod under different fed conditions. A numerical deconvolution approach was used to obtain the tegaserod oral absorption versus time profiles under both fasted and fed conditions. The tegaserod oral absorption versus time profiles were then fitted by NONMEM to a model containing two absorption phases. Based on the absorption analyses, we found that the reduction in the bioavailability of tegaserod under fed conditions was primarily due to a decrease in the extent of absorption and less so to a decrease in the absorption rate(s). Therefore, although the timing of administration of food does not appear to significantly alter the pharmacokinetics of tegaserod, the administration of food reduces the AUC by approximately 50%.

Adult↗
PubMed1999

An evaluation of the carcinogenic potential of the herbicide alachlor to man.

Chronic bioassays have revealed that alachlor caused nasal, thyroid, and stomach tumours in rats but was not carcinogenic in mice. Significant increases in thyroid and stomach tumours were observed only at doses that exceeded the maximum tolerated dose (MTD). While nasal tumours were found at doses below the MTD, they were small and benign in nature. This publication describes the work undertaken by Monsanto to understand the carcinogenic mode of action of alachlor in the rat and to investigate the relevance to humans. The genetic toxicity of alachlor has been investigated in an extensive battery of in vitro and in vivo test systems. In addition, target-specific mutagenicity tests, such as the COMET assay and DNA binding in nasal tissue, were carried out to investigate any possible in-situ genotoxic action. The weight-of-evidence analysis of all available data clearly demonstrates that alachlor exerts its carcinogenicity in the rat by non-genotoxic mechanisms. In the rat, alachlor is initially metabolised primarily in the liver through the P-450 pathway and by glutathione conjugation. The glutathione conjugates and their metabolites undergo enterohepatic circulation with further metabolism in the gastrointestinal tract, liver, and then nasal tissue where they can be converted to a diethyliminoquinone metabolite (DEIQ). This electrophilic species binds to the cysteine moiety of proteins leading to cell damage and increased cell turnover. When comparisons of in vitro nasal metabolic capability were made, the rat's capacity to form DEIQ from precursor metabolites was 38 times greater than for the mouse, 30-fold higher than monkey, and 751 times greater than that of humans. This data is consistent with the results of studies showing in vivo formation of DEIQ-protein adducts in the nasal tissue of rats but not mice or monkeys. The lack of DEIQ nasal adducts in mice is consistent with the lack of nasal tumours in that species. When the differences between rat and humans in the capacity for initial glutathione conjugation by the liver and nasal tissue are also taken into account, the rat is found to be even more susceptible to DEIQ formation than man. Based on this, it is clear that the potential for DEIQ formation and nasal tumour development in humans is negligible. The mechanism of stomach tumour formation has been studied in the rat. The results demonstrated that the mechanism is threshold-sensitive and involves a combination of regenerative cell proliferation and a gastrin-induced tropic effect on enterochromaffin-like (ECL) cells and stem cells of the mucosal epithelium. The absence of a carcinogenic effect in mice and of any preneoplastic effect in monkeys treated with very high doses is indicative ofthe species-specific aspect of this mechanism of action. The results of studies on thyroid tumour production indicate that alachlor is acting indirectly through the pituitary-thyroid axis by increasing the excretion of T4 by enhanced glucuronidation and subsequent biliary excretion. The increased excretion reduces plasma T4 levels and a feedback mechanism leads to increased synthesis of TSH by the pituitary. Chronic stimulation of the follicular epithelium of the thyroid by TSH produces hyperplasia and ultimately tumour formation. This non-genotoxic, threshold-based mechanism is well established and widely considered to be not relevant to humans. In this work, the modes of action for the three types of tumours elicited in the rat by alachlor were investigated. All are based on non-genotoxic, threshold-sensitive processes. From all the data presented it can be concluded that the tumours detected in the rat are not relevant to man and that alachlor presents no significant cancer risk to humans. This conclusion is supported by the lack of mortality and tumours in an epidemiology study of alachlor manufacturing workers.

Acetamides↗
PubMed1999

Immediate stenting of iliofemoral occlusive lesions: a surgeon's early experiences.

PURPOSE: To report the early and midterm results of balloon angioplasty and immediate stenting of atherosclerotic iliofemoral lesions in an operating room setting. METHODS: Sixty-one patients (41 men, mean age 70 +/- 8 years, range 49 to 86) underwent balloon dilation and systematic stenting for 80 stenotic and occlusive lesions in the iliac (n = 47) and superficial femoral (n = 33) arteries in 72 limbs. One hundred two stents (63 VascuCoil, 33 Wallstent, and 6 miscellaneous) were placed. Patients were followed with serial duplex scans at 3-month intervals. RESULTS: Initial technical success by intention-to-treat was 96.2% (77/80) (iliac: 100%, femoral: 90.9% [30/33]). There were 9 (11.3%) procedure-related complications and no deaths. Initial success by anatomic, hemodynamic, and clinical limb criteria were 100%, 95%, and 94.4%, respectively. Thirty procedures were performed for limb salvage with a success rate of 86.7%. Six patients (7 limbs) died during follow-up of unrelated causes. Fifty-nine (81.9%) limbs were available for duplex follow-up over a mean 17.7 months (range 3 to 37). Cumulative patency rates were 87.3% at 2 years for iliac stents and 66.6% at 18 months for femoral stents with an overall 2-year patency rate of 76.3%. The only independent risk factors affecting late patency were the site of angioplasty, stent diameter, lesion grade, and the preoperative ankle-brachial index. Stents placed with a diameter < or = 5 mm and > 5 mm had 1-year patency rates of 51.0% and 97.6%, respectively (p = 0.004) CONCLUSIONS: Iliac and femoral angioplasty and immediate stenting have acceptable midterm patency rates. The patency of femoral stenting is inferior and is adversely affected by stents < or = 5 mm in diameter.

Aged↗
PubMed1999

Carotid endarterectomy for carotid stenosis: audit at a tertiary referral centre.

Prospective randomised controlled trials performed in North America and Europe have demonstrated that the risk of future stroke or death is substantially reduced by performing carotid endarterectomy in symptomatic patients who have severe carotid stenosis. An audit was conducted to analyse the results of carotid endarterectomy performed during a 3-year period, at a tertiary referral vascular centre in Hong Kong. A total of 35 patients who had significant carotid stenosis underwent 36 carotid endarterectomies from October 1994 to September 1997. All patients recovered uneventfully without neurological complications or mortality. The audit showed that the current results of carotid endarterectomy at this institution fulfilled the criteria advised by the Stroke Council of the American Heart Association in 1995. Therefore, carotid endarterectomy is a validated therapeutic option for carotid stenosis in Hong Kong.

Journal Article↗
PubMed1998

Long term prognosis after hepatectomy for hepatocellular carcinoma: a survival analysis of 204 consecutive patients.

BACKGROUND: Intrahepatic recurrence continues to be the main cause of late death among hepatocellular carcinoma patients after hepatic resection. The aims of the current study were to identify the prognostic factors affecting long term survival and to evaluate the clinical value of pTNM classification as a prognostic factor for these patients. The identification of significant prognostic factors plays an important role in the selection of patients for postoperative adjuvant therapy and counseling. METHODS: From January 1989 to August 1995, 204 consecutive patients underwent hepatectomy for hepatocellular carcinoma. The overall cumulative and disease free survival rates for these patients were analyzed. Univariate and multivariate analyses of 16 clinicopathologic factors, including factors associated with pTNM classification, were performed to determine the significant prognostic factors. RESULTS: The median periods of overall cumulative survival and disease free survival were 35 months and 12.4 months, respectively. By univariate analysis, all factors associated with tumor (T) classification, namely, tumor size, vascular invasion, the number of tumor nodules, and tumor localization, were correlated with survival. By Cox regression analysis, preoperative indocyanine green retention value at 15 minutes, tumor size, and number of tumor nodules were independent prognostic factors of long term survival, whereas the number of tumor nodules, tumor size, and venous permeation were the most powerful predictors of tumor recurrence. The cumulative 5-year survival rates for patients with Stages I, II, III, and IVA tumors were 72%, 55%, 34%, and 8%, respectively. Significant differences in cumulative survival curves were observed among the categories of pTNM classification. CONCLUSIONS: The results of this study showed that pTNM classification correlated well with postoperative survival. Preoperative evaluation of hepatic functional reserve with an indocyanine green clearance test plays an important role in determining the long term prognoses of patients with hepatocellular carcinoma.

Adolescent↗
PubMed1998

Intraoperative endovascular angioplasty and stenting of iliac artery: an adjunct to femoro-popliteal bypass.

BACKGROUND: With the rapid development of endovascular techniques, the management strategy of patients with multilevel atherosclerotic arterial occlusive disease is also evolving. Iliac artery stenting is a means whereby multiple bypass operations can be avoided in such patients. The early results of preoperative iliac artery stenting seem promising but the role of intraoperative iliac artery angioplasty and stenting is less clear. STUDY DESIGN: This study was undertaken to evaluate our early results of a combined endovascular and operative approach to patients with multilevel atherosclerotic arterial occlusive disease. Between June 1995 and March 1997, primary intraoperative iliac artery balloon angioplasty and stent placement were performed on 13 affected limbs of 12 patients undergoing an infrainguinal bypass operation. Indications for operation, patient demographics, and risk factors were noted. The outcome of surgery and the patency rates of bypass graft and stent were also recorded. RESULTS: The initial technical success of primary iliac artery angioplasty and stenting was 93%. An improvement of the ankle-brachial index by a mean value of 0.38 was attained after operation (p < 0.001). Clinical success, based on the criteria suggested by the Society for Vascular Surgery/International Society for Cardiovascular Surgery, was achieved in all patients. There was no operative or hospital mortality. Postoperative morbidity rate was 8% (n = 1). The cumulative 1-year patency rates of iliac stent and infra-inguinal bypass grafts were 100% and 85%, respectively. The limb loss rate was 7%. CONCLUSIONS: The technique of intraoperative angioplasty and stenting can be easily mastered by an experienced and skilled vascular surgeon, using a portable C-arm fluoroscopic unit, in the operation theater. A combined endovascular and operative approach optimizes the therapeutic option to this selected group of patients.

Aged↗
PubMed1998

Takayasu arteritis--a case report of aortic aneurysm.

Aortic pseudo-aneurysm is a rare manifestation of Takayasu arteritis. We present a 16-year-old girl who first complained of multiple arthritis, recurrent abdominal pain and malaise at the age of 15 years. The initial working diagnosis was juvenile rheumatoid arthritis. Follow-up abdominal ultrasonography for her hepatomegaly incidentally revealed an aortic aneurysm. Total aortography showed diffuse aortic narrowing and an infra-renal aortic pseudo-aneurysm. Vascular reconstruction with an interposition Dacron graft was performed with uneventful recovery. Early non-specific presentation of Takayasu arteritis often results in delay of diagnosis. The presence of a vascular bruit in a young female with non-specific symptoms should point to a differential diagnosis of Takayasu arteritis. We review the role of surgery in the management of this condition.

Abdominal Pain↗
PubMed1997

Prospective evaluation of vacuum pleural drainage after thoracotomy in patients with esophageal carcinoma.

OBJECTIVE: To evaluate the safety and efficacy of vacuum pleural drainage systems in selected patients. DESIGN: Prospective nonrandomized study. SETTING: Division of Upper Gastrointestinal Surgery at a tertiary care center. PATIENTS AND INTERVENTION: Between January 1, 1995, and December 31, 1995, 32 patients underwent a right-sided posterolateral thoracotomy for the resection of esophageal carcinoma. A vacuum drain was employed in 21 patients (group 1) and an under-water drain in 11 patients (group 2). The selection of patients for vacuum drainage was based on minimal pleural adhesions and technical ease of the operation. MAIN OUTCOME MEASURE: Data on drainage efficiency, total drainage output and duration of the drain being left in situ, and postoperative pulmonary complications were analyzed. RESULTS: The median total drainage outputs were 1280 mL and 1230 mL (P = .92, Mann-Whitney U test) in groups 1 and 2, respectively, and the median duration of chest drains being left in situ was 7 days and 6 days (P = .11, Mann-Whitney U test) in groups 1 and 2, respectively. Postoperative pulmonary complications occurred in 5 patients (24%) enrolled in group 1 and 5 patients (45%) enrolled in group 2 (P = .09, Fisher exact test). No hospital mortality was reported during the study. CONCLUSION: The vacuum drain has proved to be as safe and efficient as the traditional underwater drain, imposing less discomfort and allowing early mobilization. The vacuum drain is, therefore, recommended in selected patients undergoing thoracotomy for esophageal resection.

Drainage↗
PubMed1997

Effect of psyllium in hypercholesterolemia at two monounsaturated fatty acid intakes.

We performed two studies to determine whether the lipid-lowering effect of viscous soluble fiber was modified by monounsaturated fatty acid (MUFA). First, psyllium (1.4 g/MJ) was compared with wheat bran (control) in 1-mo metabolic diets by using a randomized crossover design (n = 32 hyperlipidemic subjects). The background diet contained approximately 6% of energy as MUFA (20% of total fat). The second study (n = 27 hyperlipidemic subjects) was similar to the first but the background diet contained approximately 12% MUFA (29% of total fat) because of the addition of canola oil. At both fat intakes, psyllium resulted in significant reductions in total, low-density-lipoprotein (LDL), and high-density-lipoprotein (HDL) cholesterol compared with the wheat bran control. For the psyllium diet at 6% compared with 12% MUFA, the decreases in LDL cholesterol were 12.3 +/- 1.5% (P < 0.001) and 15.3 +/- 2.4% (P < 0.001), respectively. With the higher-MUFA diet triacylglycerol fell significantly over the control phase (16.6 +/- 5.5%, P = 0.006) and the ratio of LDL to HDL cholesterol fell significantly over the psyllium phase (7.3 +/- 2.8%, P = 0.015). Psyllium and MUFA intakes were negatively related to the percentage change in the ratio of LDL to HDL cholesterol (r = -0.34, P = 0.019 and r = -0.44, P = 0.002, respectively). Chenodeoxycholate synthesis rate increased (30 +/- 13%, P = 0.038) with the psyllium diet in the 12 subjects in whom this was assessed. We conclude that psyllium lowered LDL- and HDL-cholesterol concentrations similarly at both MUFA intakes. However, there may be some advantage in combining soluble fiber and MUFA to reduce the ratio of LDL to HDL cholesterol.

Apolipoproteins B↗